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Bone Marrow Pathology Evaluation

Test Code



Hematologic Malignancies


Microscopic evaluation of bone marrow biopsy / clot prep (H&E) and peripheral / aspirate smears;
additional stains as required (iron, immunohistochemistry)

Turnaround Time

3 days

Specimen Requirements

1 cm bone marrow core biopsy in formalin or B Plus fixative
4 mL (min. 0.5 mL) bone marrow aspirate in EDTA; sodium heparin for cytogenetics
5 mm^3 bone marrow aspirate clot in formalin for B-Plus
4-6 air-dried marrow aspirate smear slides
1 peripheral blood smear slide
Please include a CBC report

Specimen Stability
Bone marrow core biopsy and aspirate clot are stable up to 72 hours at 18-25°C
Aspirate smears and blood smears are stable indefinitely at 18-25°C
Bone marrow aspirate and EDTA samples, stable 48 hours at 18-25°C
Storage & Handling

Protect from extreme temperature with ice pack. Separate ice pack from specimen.

Causes for Rejection

Improper specimen labeling; Inadequate marrow for evaluation; Improper sample submission; Formalin leakage in transit can render slides uninterpretable

Reference Range

Active cellular marrow; No cells diagnostic of malignancy


A board-certified hematopathologist / pathologist evaluates bone marrow morphology for malignancy, dysplasia and non-neoplastic disease in context with provided clinical information and ancillary clinical findings. Unless otherwise requested, iron stains are routinely performed to assess iron storage and pathologic erythroid iron. Aspirate smears are reviewed and differential is reported.  Submission of peripheral smears and CBC data are required for optimal interpretations. Results of flow cytometric, immunohistochemical, cytogenetic or molecular analyses, when performed, are integrated in the final report.


Foucar.(2001). Bone Marrow Pathology 2nd edition. ASCP Press.